Highlightshttp://advancingyourhealth.org/highlights
Emory highlightsFri, 27 Jul 2018 19:16:33 +0000en-UShourly1https://wordpress.org/?v=4.9.7The Catching Point: Gaining Enough Momentum to Make Weight Loss Easierhttp://feedproxy.google.com/~r/emoryhealthcare/highlights/~3/7VW4-19SYoc/
http://advancingyourhealth.org/highlights/2018/06/29/5-diet-tips-weight-loss/#respondFri, 29 Jun 2018 16:16:51 +0000http://advancingyourhealth.org/highlights/?p=3403One thing is clear regarding healthy diet and exercise: it is much easier for those who are already lean to do it for body maintenance than it is for those who are obese trying to make a change. People hoping to lose pounds quickly by abruptly starting to exercise and eat well ignite a survival […]

]]>One thing is clear regarding healthy diet and exercise: it is much easier for those who are already lean to do it for body maintenance than it is for those who are obese trying to make a change. People hoping to lose pounds quickly by abruptly starting to exercise and eat well ignite a survival response that turns hundreds of thousands of would-be dieters back each year.

The nature of the survival response is a subject for another article, but for now – how can we overcome it? How can we get that critical amount of momentum, after which things are so much easier? How can we stay on track long enough so that habits “catch?”

The traditional teaching is to push through it and overcome the early entry barrier with “mind over matter” techniques. Unfortunately, that approach has contributed to notoriously high diet failure rates and continually increasing incidences of obesity. In recent years, the obesity medicine literature has provided us with new options that address sustainability. These principles help patients stay engaged long enough so that healthy living gets easier; long enough to reach a “catching point.”

1. Something is better than nothing.

The American Heart Association, Centers for Disease Control, and the American College of Cardiology (among others) categorically agree that “progress, not perfection” should be the goal. Time and time again, the pursuit of perfection leads to failure. The inability to keep a predetermined schedule leads to the all-or-nothing decision to “quit your diet.” Dieters should strive to accumulate as much change as possible in the long run. That is, successful weight loss will come for the person who is persistent about accumulating 15 workouts or 15 healthy meals or 15 recoveries in total, rather than necessarily in a specified amount of time (i.e., 10 pounds in 10 days).

2. Flexibility is associated with success in weight loss.

Rigid structure leads to failure. People cannot follow generalized day-by-day schedules for a host of reasons: the body rebels, life gets in the way, motivation wanes, etc. Weight Watchers® is endorsed by many medical groups and has been successful largely because of its implementation of flexibility to obtain the long-term goal. The same principle is helpful for staying on track regarding fitness, recovery, and diet.

3. Recovery is essential for actual body change to take place.

Successful people in the fitness space attend to recovery. Obese individuals generally lack the exercise capacity to significantly affect calorie balance. These individuals should employ exercise in this space to induceadaption, so that they will improve their ability to burn absolute calories and their bodies will initiate neural signals from the periphery to the brain (outside-in) that will ease their burden of exercise.

4. Concepts are proven effective in weight loss.

The concepts of self-monitoring, stimulus control, specific nutritional choices, motivational interviewing, and physical activity are proven effective in weight loss. A combination of these techniques may accelerate dieters through the stages of change toward long-term effect.

5. The hunger hormone system can be bypassed and appetite can be changed.

A complex system of hunger hormones exists that drives human beings to eat in order to survive. This system is responsible for the intense hunger pangs, fatigue, and motivation “zap” that follow the onset of calorie restriction and new exercise. This system can be modified, through careful (intentional) activity and supplemented recovery, to keep dieters on track.

The goal of these principles is to change failure rates. There is no question that the great majority of available diet and exercise programs would indeed lead to weight loss if completed. The pandemic issue is that people quit them. Attention to these principles may help dieters stay engaged long enough for the lifestyle to “catch” and the survival response to diminish.

About J. David Prologo, MD

J. David Prologo, MD, FSIR, ABOM-D is a dual board-certified interventional obesity medicine specialist. He is a nationally recognized expert in ablative therapies and has pioneered several interventions for the management of obesity through sustainability, including the freezing of the hunger nerve and catching point capacity curve. Dr. Prologo’s research focus is on helping patients “not quit their diets.” Specifically, he works to make dieters successful by managing the body’s resistance to change.

MAGNET RECOGNITION PROGRAM® — SITE VISIT

Emory University Hospital was designated as a Magnet organization in 2014 by the ANCC Magnet Recognition Program®. This prestigious designation recognizes excellence in nursing services. In August, 2018, Emory University Hospital is applying for re-designation.

Patients, family members, staff, and interested parties who would like to provide comments are encouraged to do so. Anyone may send comments via e-mail and direct mail. All comments received by phone must be followed up in writing to the Magnet Program Office.

Your comments must be received by the Magnet Program Office by Friday, July 27, 2018.

NOTE: All comments are CONFIDENTIAL and are not shared with the health care organization. Comments may be anonymous, but they must be sent in writing to the Magnet Program Office.

]]>http://advancingyourhealth.org/highlights/2018/06/27/public-notice-magnet-recognition-program-site-visit/feed/0http://advancingyourhealth.org/highlights/2018/06/27/public-notice-magnet-recognition-program-site-visit/Congratulations to Emory’s 2018 Atlanta Top Doctorshttp://feedproxy.google.com/~r/emoryhealthcare/highlights/~3/-ETJft_qXDo/
http://advancingyourhealth.org/highlights/2018/06/21/congratulations-emorys-2018-atlanta-top-doctors/#respondThu, 21 Jun 2018 23:59:49 +0000http://advancingyourhealth.org/highlights/?p=3395Once again, Atlanta magazine’s July 2018 Top Doctors issue features the annual listing of Top Doctors in the metro Atlanta area. We are proud to announce that of all the health systems represented on the list, Emory Healthcare has more Top Docs than any other health system in Atlanta. Emory physicians represented 42% of the […]

]]>Once again, Atlanta magazine’s July 2018 Top Doctors issue features the annual listing of Top Doctors in the metro Atlanta area. We are proud to announce that of all the health systems represented on the list, Emory Healthcare has more Top Docs than any other health system in Atlanta. Emory physicians represented 42% of the total doctors recognized – 329 Emory physicians to be exact.

These physicians include those who practice at one of our six hospitals and over 200 provider locations, as well as those who hold faculty positions at the Emory University School of Medicine.

We honor, celebrate and thank all of our 2018 Atlanta Top Doctors—and their outstanding care teams—for providing exceptional care to our patients and families, and for truly making patient- and family-centered care their priority each day. Congratulations to you all!

To compile the annual “Top Doctors” list, Castle Connolly uses a survey and research process involving tens of thousands of top doctors across America and the medical leadership of leading hospitals. Atlanta’s top doctors are selected after peer nomination, extensive research, careful review and screening by Castle Connolly’s doctor-directed research team. Atlanta magazine uses the research by Castle Connolly to provide detailed information about education, training and special expertise of Atlanta doctors. Doctors do not and cannot pay to be selected and profiled as Castle Connolly “Top Doctors.”

As our Emory Healthcare family continues to grow, so too does our ability to provide Atlanta and Georgia residents access to more top healthcare providers. Communities all over Georgia now have access to more Emory top doctors. Big or small, major or minor, if you have a reason to seek medical care, there is an Emory Healthcare facility and an Emory Healthcare Network physician near you.

The Emory Healthcare Network is a clinically integrated network through which we provide access to coordinated patient- and family-centered care. With six hospitals, over 200 provider locations and 2,000 physicians in more than 70 specialties, the Network delivers care through a full range of hospitals, clinics and local practices, including more than 120 primary care locations, over 20 urgent care locations, and 38 MinuteClinics.

]]>http://advancingyourhealth.org/highlights/2018/06/21/congratulations-emorys-2018-atlanta-top-doctors/feed/0http://advancingyourhealth.org/highlights/2018/06/21/congratulations-emorys-2018-atlanta-top-doctors/Exercising While Pregnanthttp://feedproxy.google.com/~r/emoryhealthcare/highlights/~3/8bUUqp9DTN0/
http://advancingyourhealth.org/highlights/2018/05/18/exercising-for-2-or-more/#respondFri, 18 May 2018 17:53:30 +0000http://advancingyourhealth.org/highlights/?p=3389“I’m worried if I run, that I will hurt my baby.” “If I continue to do Pilates, will I squish my little one?” “Can I keep doing Cross Fit?” “I’ve never really exercised before…can I start now that I’m pregnant?” These are some common questions pregnant patients ask during visits and understandably so as there […]

“I’ve never really exercised before…can I start now that I’m pregnant?”

These are some common questions pregnant patients ask during visits and understandably so as there is so much conflicting information out there. Hopefully, this will shed some light on the subject.

What is exercise? Why should I make it a part of my routine?

Exercise, defined as a planned activity with the intention of improving one or more components of physical fitness, has been shown to have many positive benefits for a person in pregnancy. Pregnant patients who have maintained a regular exercise schedule have shown to gain a healthier amount of weight during pregnancy, lose excess weight more quickly after delivery, reduce the risk of medical conditions related to pregnancy such as gestational diabetes, preeclampsia, and cesarean sections, as well as, an overall improved feeling of well-being during pregnancy itself.

To Exercise or Not to Exercise

First, before starting an exercise program, it is important that you speak with your provider and understand if your pregnancy is high or low risk. There are certain conditions in which exercise in pregnancy may be unsafe, such as:

Significant heart or lung disease

Incompetent cervix or cerclage

Multiple pregnancies at risk for preterm labor

Bleeding in the second or third trimester

Placental concerns

Premature labor during the current pregnancy

Premature rupture of membranes

Pre-eclampsia or high blood pressure in pregnancy

Severe anemia

For those who are considered to have a low-risk pregnancy, there are very few limitations on what you can do. It is recommended that healthy pregnant people get 150 minutes of moderate-intensity aerobic activity divided over the course of a week, (i.e., brisk walking, water aerobics, bicycling slower than 10mph).

If one has regularly participated in more vigorous-intensity activity or who may be considered highly active prior to pregnancy, they may consider continuing these activities during pregnancy, safely, with modifications as needed. Some examples of vigorous-intensity include: running, swimming laps, hiking uphill, bicycling more than 10mph, or high-intensity interval training.

If one has not been very active prior to pregnancy, it is ok to start during pregnancy. It is just important to start slowly and build up. Consider setting a time goal for yourself for about 10-15 minutes for the first few weeks, adding about 10 minutes or so until you hit the goal of about 30 minutes. It may take a few weeks to achieve your goal, but that’s ok. Consistency is key.

Activities to consider avoiding when pregnant:

Skydiving

Scuba diving

Activities with a high risk of falling/abdominal trauma, ie. Water skiing, surfing, off-road cycling, horseback riding

Contact sports

Hot yoga or hot Pilates

How much is too much?

It used to be thought that a pregnant person should not increase their heart rate above a certain level with exercise. However, this has been proven to be inaccurate. It is more accurate by monitoring your level of exertion – if it feels hard, it likely is (see table 1 below). Another way is to do that is by the “talk test.” If you are able to carry on a conversation while exercising, it is likely that you are not overexerting yourself.

While performing physical activity, it is encouraged that you rate your perception of exertion. This feeling should reflect how heavy and strenuous the exercise feels to you, combining all sensations and feelings of physical stress, effort, and fatigue. Do not concern yourself with any one factor such as leg pain or shortness of breath but try to focus on your total feeling of exertion.

Try to appraise your feeling of exertion as honestly as possible, without thinking about what the actual physical load is. Your feeling of effort and exertion is important, not how it compares to others. Look at the rating scale below while you are engaging in an activity; it ranges from 6 to 20, where 6 means “no exertion at all” and 20 means “maximal exertion.” Choose the number from below that best describes your level of exertion. This will give you a good idea of the intensity level of your activity, and you can use this information to speed up or slow down your movements to reach your desired range.

Important Considerations

With pregnancy, your center of gravity changes as the curve in the lower back increases. Therefore, modifications to your exercise practice may be needed. Additionally, laying on your back for prolonged periods of time should be avoided. Working with your instructor and listening to your body is very important. If it hurts, you feel unbalanced, dizzy, or any other concerns, then consider stopping that particular movement and moving to the next one. Or, you may want to stop completely. Persistent pain or discomfort warrants evaluation by a health care provider.

Remember that it is important to stay adequately hydrated while exercising and to ensure adequate caloric intake, especially before engaging in high-intensity or prolonged exercise. Again, listening to your body is very important!

Stop exercising if you experience…

Vaginal bleeding

Contractions that are regular and painful

Concern for the leaking of fluid

Shortness of breath or difficulty breathing before exercise

Headache

Chest pain

Concern for balance

Calf pain or swelling

Staying Motivated

Again, consistency is key! Sometimes having a partner to work-out with may be helpful. Group prenatal exercise classes may offer the social setting to accomplish the goal of achieving physical fitness while establishing relationships with other expectant parents. Prenatal exercise DVDs or streaming prenatal work-outs may also help, giving the option of convenience to working out.

Bottom Line

It is safe to start exercising or continue to exercise in low-risk pregnancies after discussing with your health-care provider. Exercise is an important part of maintaining good physical and mental health and has been shown to have positive benefits during pregnancy.

To schedule an appointment with an Emory Women’s Center Obstetrician,
call our appointment line at 404-778-3401.

]]>http://advancingyourhealth.org/highlights/2018/05/18/exercising-for-2-or-more/feed/0http://advancingyourhealth.org/highlights/2018/05/18/exercising-for-2-or-more/Sexual Dysfunctionhttp://feedproxy.google.com/~r/emoryhealthcare/highlights/~3/q05Kq-Wl2SM/
Wed, 18 Apr 2018 17:48:39 +0000http://advancingyourhealth.org/highlights/?p=3383What you may have been labeling as “lack of sexual interest” or “painful sex” is a form of sexual dysfunction, a common and frequently treatable issue. The term “sexual dysfunction” refers to a recurring or persistent problem that interferes with a person’s ability to have sex or enjoy a sexual experience. Sexual dysfunction can occur […]

]]>What you may have been labeling as “lack of sexual interest” or “painful sex” is a form of sexual dysfunction, a common and frequently treatable issue. The term “sexual dysfunction” refers to a recurring or persistent problem that interferes with a person’s ability to have sex or enjoy a sexual experience. Sexual dysfunction can occur at any point in a woman’s life. The process of sexual enjoyment is complex, especially in women. There are multiple points at which the “dysfunction” can occur, and many times there is more than one factor at play.

Common problems which can occur include:

Low desire or the lack of sexual interest

Lack of arousal or difficulty maintaining the arousal

Inability to achieve orgasm

Pain instigated by intercourse or chronic pain preventing intercourse

Low desire, lack of arousal and inability to achieve an orgasm can be due to:

Medications, such as anti-depressants, high blood pressure medication, alcohol, and illicit drugs.

Mental state as it relates to the relationship with your partner, cultural or religious issues as it pertains to the act of sex, and issues with body image.

History of sexual abuse and post-traumatic stress disorder, or a negative sexual experience.

Menopause

Menopause is the point in life where the body no longer produces estrogen. Natural menopause is defined as no menses for one year. You may be at the point where menses may be present but irregular, which is referred to as peri-menopause. Sexual function can change both with peri-menopause and menopause, as well as with surgical menopause (when the ovaries are removed surgically). This is due to the lack of estrogen in the vagina which makes the vagina drier, less elastic or flexible, and decreases the blood flow to the area causing the vaginal skin to become thinner.

Pain

Vaginal pain can be caused by other reasons beyond hormonal changes, especially in women who are premenopausal. Pain disorders can cause sexual dysfunction cycles which can be a challenge to break. One can experience pain with intercourse, vaginal dryness, constant vaginal/pelvic/lower abdominal pain, and vaginal irritation which may be mistaken for vaginal infections or urinary tract infections. However, the negative experience associated with a painful sexual experience can trigger an ongoing sexual dysfunction cycle.

Steps to Addressing Pain with Intercourse

The first step is to identify what is prompting the pain (there may be more than one contributing reason), then to focus therapies (more than one therapy simultaneously is often necessary):

An anatomic issue with the vagina—Sometimes if a woman is dealing with a scar tissue band or pelvic organ prolapse/vaginal bulge this may change the anatomy (the shape) of the vagina. This change in structure may result in painful intercourse. Addressing these anatomical changes may require pelvic floor physical therapy or surgery to correct the issue.

Pelvic floor dysfunction—If you have experienced pain with intercourse or even without intercourse, the cause may be abnormally tight pelvic muscles. This inability to relax pelvic floor muscles may cause abnormal feedback to pelvic organs causing pain, bladder dysfunction or anorectal dysfunction. Pelvic floor physical therapy is the most commonly prescribed treatment, but other therapies may be necessary in conjunction with physical therapy to achieve better sexual function and alleviate pain.

Vulvovaginal skin changes— The thinning of the walls of the vagina caused by decreased estrogen levels is a change in the vagina that occurs with menopause, and sometimes during the peri-menopausal period. There are hormonal and non-hormonal therapies which can be initiated for treatment. Other times, hormonal changes may not be the issue. Lichen sclerosus is an autoimmune skin condition of the vulva (outside of the vagina) which can cause irritation and pain. The treatment for lichen sclerosus is different and will need a biopsy first to confirm the diagnosis.

Interstitial cystitis (IC) or Bladder Pain Syndrome—This is a condition of the bladder which can cause bladder pain, urinary urgency and frequency, and painful intercourse. IC often makes one think she has urinary tract infections but will have negative urine cultures. There are many ways to try to alleviate IC which include diet changes, pelvic floor physical therapy, stress management, or medications.

Stress and anxiety, history of sexual abuse—Finding outlets or methods to manage stress and anxiety are paramount to break the pain cycle. Psychotherapy is very important with pain and anxiety disorders, as well as, with a history of sexual abuse to obtain better overall function and strengthen relationships thus helping sexual function.

Other medical issues may cause pelvic pain and pain with intercourse such as endometriosis and irritable bowel syndrome. Other specialists may need to be involved in helping manage these issues.

Multidisciplinary approaches with pelvic floor physical therapists, psychiatrists/counselors, gynecologist or urogynecologist, and other specialists such as urologists and gastroenterologists are often required for managing pain disorders or painful disorders.

Talking to your primary care physician or gynecologist openly about your sexual dysfunction, and how it is impacting your life and relationships is a necessary first step. Your physician may be able to help you or may refer you to a specialist. Therapy will take time, especially since there is no “magic cure” for sexual dysfunction. However, with positive steps in the right direction, sexual function can be improved.

About Sana Ansari, MD

Sana Ansari, MD is a Urogynecologist and Pelvic Reconstructive Surgeon with Emory Women’s Center, and Assistant Professor at Emory University School of Medicine. Her specialties include Female Pelvic Medicine & Reconstructive Surgery, Urogynecology, and Obstetrics and Gynecology. She is currently accepting patients at Emory Johns Creek Hospital and Emory Saint Joseph’s Hospital.

]]>http://advancingyourhealth.org/highlights/2018/04/18/sexual-dysfunction/Pelvic Floor Dysfunction – What is the Right Treatment Approach?http://feedproxy.google.com/~r/emoryhealthcare/highlights/~3/IhEpwShpjcA/
Mon, 02 Apr 2018 12:14:15 +0000http://advancingyourhealth.org/highlights/?p=3377Pelvic floor dysfunctions are common and include a wide range of conditions that affect women on a daily basis, significantly impairing one’s quality of life. In the United States, up to 35% of women suffer from stress urinary incontinence (SUI), and up to 50% of women have physical findings consistent with some degree of pelvic […]

]]>Pelvic floor dysfunctions are common and include a wide range of conditions that affect women on a daily basis, significantly impairing one’s quality of life. In the United States, up to 35% of women suffer from stress urinary incontinence (SUI), and up to 50% of women have physical findings consistent with some degree of pelvic organ prolapse.

Symptoms

At Emory Women’s Center, our Female Pelvic Medicine and Reconstructive Surgery specialists offer help to patients with a wide variety of conditions including pelvic organ prolapse (when the pelvic organs “drop” due to pelvic floor weakness) and stress urinary incontinence (the involuntary leakage of urine with physical activity).

Nonsurgical Options

There is a broad range of treatment options for these two conditions. Nonsurgical options may include:

Adopting lifestyle changes

Strengthening your pelvic floor muscles with specific pelvic exercises with or without the help of a pelvic floor physical therapist

Using a pessary – removable device that is placed into the vagina to support areas of prolapse

While these nonsurgical options are explored with all patients, you may find that surgery is often an option to solve issues related to bowel or bladder pain or even painful sexual intercourse. One in six women will opt for surgery. The use of permanent mesh material to reinforce the prolapsed area is one of the many successful surgical approaches. This has many patients wondering, “is the use of mesh right for me?”

Surgical Option: Mesh

Mesh, also known as Polypropylene mesh, has been used for decades across most surgical subspecialties. In recent years, the use of mesh has garnered a lot of media attention. Centered around the July 2011 U.S. Food and Drug Administration (FDA) advisory on the safety and effectiveness of mesh, the treatment of pelvic organ prolapse media coverage may raise questions about whether the mesh is right for your specific Pelvic Disorder needs. Transvaginal mesh as it is mentioned in the 2011 FDA is different from our use of mesh augmentation materials for pelvic floor disorders. When treating pelvic organ prolapse, the mesh is placed abdominally, a technique that has been used for many years offering lower complication rates.

We also use vaginal mesh to treat stress urinary incontinence in the form of mid-urethral slings. This leading surgical treatment option for women who suffer from SUI is supported as the “standard of care” in the surgical treatment of stress urinary incontinence by the American College of Obstetrics and Gynecology (ACOG), the American Urogynecologic Society (AUGS) and the Society of Urodynamics, Female Pelvic Medicine & Urogenital Reconstruction (SUFU).

If you suffer from vaginal prolapse or stress urinary incontinence, don’t hesitate to consult an Emory Clinic Female Pelvic Medicine and Reconstructive Surgery subspecialist and ask them if surgery is right for you. The Female Pelvic Medicine and Reconstructive Surgery team at Emory Clinic’s Department of Gynecology and Obstetrics includes specialized pelvic surgeons, colorectal surgeons and a dedicated group of physical therapists. Our goal is to collaborate with you to find a treatment approach tailored to your symptoms and treatment goals. Whether or not you decide on a treatment option that includes the use of permanent mesh material, our team is here to address all your urogynecological questions and concerns.

About Jessica Harroche, MD FACOG

Jessica Harroche, MD FACOG is an Assistant Professor at Emory University Department of Gynecology and Obstetrics, Female Pelvic Medicine, and Reconstructive Surgery Division. Dr. Harroche attended the Sackler School of Medicine at Tel Aviv University. She completed her Residency and Fellowship at the Albert Einstein School of Medicine/Montefiore Medical Center in the Bronx, NY. Dr. Harroche specializes in pelvic floor disorders and offers women a breadth of surgical approaches including minimally invasive procedures (vaginal, robotic).

]]>Polycystic Ovary Syndrome or PCOS is a syndrome associated with irregular menstrual cycles, acne or excess hair growth, and, occasionally, difficulties with weight control. While PCOS is a broad diagnosis, many women with PCOS do not fit the stereotypical PCOS mold. So, how do I know if I have PCOS?

A diagnosis of PCOS requires 2 of the following 3 characteristics:

Irregular menstrual cycles: Periods that occur in an unpredictable pattern or greater than 45 days apart. Women with lengthened cycles typically do not ovulate regularly.

Polycystic-appearing ovaries on transvaginal ultrasound: On an ultrasound, there are many “antral follicles,” which contain small immature eggs. Although the syndrome is called “polycystic ovary syndrome” women with PCOS have a large number of immature eggs or follicles, rather than ovarian cysts. Another hormone, called Anti-Mullerian Hormone (AMH), is often elevated in women with PCOS but this is not part of the formal diagnosis.

Given that the criteria to be diagnosed with PCOS only requires two of the three above characteristics, women may have PCOS without the commonly noted symptoms of acne, excess hair growth, or irregular cycles. Although many women with PCOS struggle with weight, diagnosis is independent of weight or body mass index (BMI). In fact, 10-15% of women with PCOS have a normal BMI. These women often do not have acne or excess hair growth and often attribute infertility to irregular menstrual cycles.

Diagnosis of Exclusion

It’s important for patients to understand that the PCOS diagnosis is a diagnosis of exclusion. This means that other syndromes or diseases can present similar symptoms to PCOS, with irregular cycles. Changes in weight and cycle irregularity can be a result of other health occurrences, such as pregnancy, thyroid disease, and elevated prolactin levels. In fact, physicians will often recommend a pregnancy test (HCG), thyroid test (TSH), and prolactin test before diagnosing PCOS.

While there are rarer diseases that can be dangerous for a woman’s health and are important to exclude as the cause of PCOS-like symptoms, ruling out pregnancy, pituitary disease, and thyroid disease is a reasonable place to start. Lifestyle factors that may contribute to absent or irregular cycles are also important to rule out prior to initiating fertility treatment. Women who have a low BMI, a history of excessive exercising or a history of caloric restriction (or a mix of the above) may experience irregular cycles. Treatment often includes lifestyle changes and support, including counseling and a nutrition referral. Women with low ovarian reserve often ovulate irregularly and may have irregular cycles. A physician will check a woman’s ovarian reserve, often with tests such as AMH, FSH, and estradiol.

Treatment Options

Lifestyle counseling is warranted in women with a diagnosis of PCOS. For women who are overweight, a 5-10% weight loss has been associated with improvement in menstrual regularity and resumption of menses. Counseling regarding the heightened risk of diabetes and pre-diabetes compared to women without PCOS may also help guide dietary and exercise choices for patients with the syndrome. Screening for diabetes should be strongly considered in any women with PCOS. If pre-diabetes is diagnosed, medication may be prescribed to aid in insulin resistance and, in some women, results in weight loss.

For those not interested in pregnancy immediately, it is important to discuss protection of the uterine lining from overgrowth or cancer. This is often done with contraceptives or an intrauterine device. Oral contraceptives have the added benefit of improvement of acne in women with PCOS. If you are interested in pregnancy, a referral to a Gynecologist or Reproductive Endocrinologist is often necessary. Women will likely need medications to induce ovulation and intercourse is then timed at home to coincide with ovulation or the medications combined with intrauterine inseminations on the day of ovulation.

PCOS affects 10-15% of reproductive-aged women and, as a result, warrants the attention of not only obstetrician-gynecologists but also physicians in other specialties.

About Dr. Jennifer Kawwass

Jennifer Kawwass, MD is the Medical Director of the Emory Reproductive Center and a Guest Researcher at the CDC. She is board certified in both reproductive endocrinology and infertility and in obstetrics and gynecology. Dr. Kawwass is a fellow of the American Congress of Obstetricians and Gynecologists and a member of the American Society of Reproductive Medicine. She received her undergraduate degree from Davidson College, her medical degree from the University Of Virginia School Of Medicine, and her Ob/Gyn and REI fellowship training from Emory.

About Dr. Heather Hipp

Heather Hipp, MD is a Reproductive Endocrinology and Infertility specialist who practices at the Emory Reproductive Center. She is a board-certified Obstetrician-Gynecologist and a fellow of the American Congress of Obstetricians and Gynecologists. She received her undergraduate degree from Duke University. She received her M.D. from Emory University School of Medicine and completed her OB/Gyn residency and REI fellowship at Emory as well.

]]>http://advancingyourhealth.org/highlights/2018/03/08/polycystic-ovary-syndrome-pcos-diagnosis-isnt-always-simple/Patient Family Advisor Spotlight – Marv Trotthttp://feedproxy.google.com/~r/emoryhealthcare/highlights/~3/hYTOJ_EaGm8/
http://advancingyourhealth.org/highlights/2017/10/05/emory-healthcare-leads-way-patient-family-advisory-councils/#respondThu, 05 Oct 2017 15:44:23 +0000http://advancingyourhealth.org/highlights/?p=3360Patient Family Advisors (PFAs) are current or former patients and family members. They volunteer their time to partner with Emory Healthcare leadership, staff, and doctors. They serve on committees, councils, project teams and other groups working in a variety of ways to improve patient care. In May 2017 one of our dear PFA’s made his transition. Marv […]

Patient Family Advisors (PFAs) are current or former patients and family members. They volunteer their time to partner with Emory Healthcare leadership, staff, and doctors. They serve on committees, councils, project teams and other groups working in a variety of ways to improve patient care.

In May 2017 one of our dear PFA’s made his transition. Marv Trott passed away in Emory University Hospital Hospice. Marv had been a PFA since 2009. He and his wife Margie were early pioneers of the Patient Family Advisory Council. This is Marv’s story…

“In 2007 Dr. Nathan Spell asked if my wife Margie and I would be interested in an Emory project called “Patient and Family Centered Care”. We agreed and Hal Jones came to our home and encouraged us to join which we (wife Margie) both did. During the next two years we both were involved in focus groups in the development of the “Care” project and as PFA’s in several projects including “Disclosure”, the “Emory University Hospital at Northlake” now known at EUOSH, and the “CarePage Website”.

In early 2009 I participated in the development of the PFAC and Margie continued as a PFA in the “Bedside Shift Report Program”. Since that time I have continued as a member of the PFAC and also have been involved as a PFA in many projects including the “Call Center”, “Portal”, ”Secret Shopper” and the latest “J Wing Expansion”. Some of these occurred before Volgistics was instituted in 2010.

Both Margie and I have been surgical patients at Emory.

In World War II, I was in the “Battle of the Bulge”. With the help from the GI bill, I graduated from the University of Rochester in 1950 with a Bachelors Degree in Electrical Engineering. In 1948 I started and operated an Electronic Design and Manufacturing company during the next 40 years. After I sold the business in 1988 I became a Mentor in SCORE which is a resource of the (SBA) US Small Business Administration. During the past 27 years, I have been actively mentoring Clients who are starting or are currently in business.”

Marv will be missed. We are forever indebted to his many contributions to the PFAC and the Office of Care Transformation.

About Patient Family Advisors

How was your experience at Emory? If you or a loved one received care at Emory, please consider becoming a Patient and Family Advisor (PFA). As a PFA, you’ll be directly involved in helping the organization make better decisions by sharing your experiences, perspectives, and expectations. as a patient or family member.

]]>http://advancingyourhealth.org/highlights/2017/10/05/emory-healthcare-leads-way-patient-family-advisory-councils/feed/0http://advancingyourhealth.org/highlights/2017/10/05/emory-healthcare-leads-way-patient-family-advisory-councils/Emory University Hospital ranked #1, Emory Saint Joseph’s #2 in Georgia & Atlantahttp://feedproxy.google.com/~r/emoryhealthcare/highlights/~3/SvDMHSE1qU4/
http://advancingyourhealth.org/highlights/2017/08/08/emory-hospital-rankings/#respondTue, 08 Aug 2017 19:50:01 +0000http://advancingyourhealth.org/highlights/?p=3358For the sixth year in a row, U.S. News & World Report has ranked Emory University Hospital the number one hospital in Georgia and in metro Atlanta in its 2017–18 Best Hospitals Guide. Emory University Hospital includes Emory University Orthopaedics & Spine Hospital and Emory University Hospital at Wesley Woods. Emory Saint Joseph’s Hospital ranked […]

]]>For the sixth year in a row, U.S. News & World Report has ranked Emory University Hospital the number one hospital in Georgia and in metro Atlanta in its 2017–18 Best Hospitals Guide. Emory University Hospital includes Emory University Orthopaedics & Spine Hospital and Emory University Hospital at Wesley Woods.

“These hospital rankings validate the commitment of care our physicians and staff provide to our patients across many different specialties at Emory,” says Jonathan S. Lewin, MD, president, CEO and Chairman of the Board of Emory Healthcare. “We appreciate our care teams and applaud them for their successes in these hospital rankings.”

U.S. News & World Report began publishing hospital rankings in 1990 to identify the best medical centers in various specialties for the most difficult patients — those whose illnesses pose unusual challenges because of underlying conditions, procedure difficulty or other medical issues that add risk. Hospitals are assessed in 16 specialties for the rankings. In 12 of the 16 specialties, the ranking is determined by an extensive data-driven analysis that combines measures of performance in three primary dimensions of healthcare: structure, process and outcomes. Ranking in the other four specialties relies on hospital reputation, as determined by physician surveys.

Within a state or metro area, regional rank is determined by a hospital’s performance in the national rankings analysis and by its scores across nine procedure and condition areas evaluated. A hospital with more national rankings in the 12 data-driven specialties outranks a hospital with fewer national rankings.

The specialty rankings and data are produced for U.S. News by RTI International, a leading research organization based in Research Triangle Park, N.C. Using the same data, U.S. News produced the state and metro rankings.

Use the links below for more ranking information and to find an Emory physician near you.

Contact Us

]]>http://advancingyourhealth.org/highlights/2017/08/08/emory-hospital-rankings/feed/0http://advancingyourhealth.org/highlights/2017/08/08/emory-hospital-rankings/Congratulations to Emory’s 2017 Atlanta Top Doctorshttp://feedproxy.google.com/~r/emoryhealthcare/highlights/~3/GLs08obtlp4/
http://advancingyourhealth.org/highlights/2017/06/23/2017-atlanta-top-doctors/#respondFri, 23 Jun 2017 08:51:03 +0000http://advancingyourhealth.org/highlights/?p=3352As our Emory Healthcare family continues to grow, so too does our ability to provide Atlanta and Georgia residents access to more top health care providers. Atlanta magazine’s July 2017 Top Doctors issue features the annual listing of Top Doctors in the metro Atlanta area. We are proud to announce that of all the health […]

]]>As our Emory Healthcare family continues to grow, so too does our ability to provide Atlanta and Georgia residents access to more top health care providers. Atlanta magazine’s July 2017 Top Doctors issue features the annual listing of Top Doctors in the metro Atlanta area. We are proud to announce that of all the health systems represented in the list, Emory physicians make up half of the doctors – 50% of 2017 Atlanta Top Doctors to be exact.

These physicians include those who practice at one of our six hospitals and over 200 provider locations, as well as those who hold faculty positions at the Emory University School of Medicine.

We honor, celebrate and thank all of our 2017 Atlanta Top Doctors—and their amazing care teams—for providing outstanding care to our patients and families, and for truly making patient- and family-centered care their priority each day. Congratulations to you all!

And with our expanding footprint, communities all over Georgia have access to more Emory top doctors. Big or small, major or minor, if you have a reason to seek medical care, there is an Emory Healthcare facility and an Emory Healthcare Network physician close to home.

To compile the annual “Top Doctors” list, Castle Connolly uses a survey and research process involving tens of thousands of top doctors across America and the medical leadership of leading hospitals. Atlanta’s top doctors are selected after peer nomination, extensive research, careful review and screening by Castle Connolly’s doctor-directed research team. Atlanta magazine uses the research by Castle Connolly to provide detailed information about education, training and special expertise of Atlanta doctors. Doctors do not and cannot pay to be selected and profiled as Castle Connolly “Top Doctors.”

The Emory Healthcare Network is a clinically integrated network through which we provide access to coordinated patient- and family-centered care. With six hospitals, over 200 provider locations and 2,000 physicians in more than 70 specialties, the Network delivers care through a full range of hospitals, clinics and local practices, including more than 120 primary care locations, over 20 urgent care locations, and 38 MinuteClinics.

The network joins Emory-employed and private practice physicians in communities throughout metro Atlanta and the state, in collaboration with Emory Healthcare, into a single comprehensive care management system.